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"Summary:This comprehensive text explains how to interpret chest radiographs and how to report that information in day-to-day practice using case examples, over 400 radiographs, drawings and specimen photographs, straightforward explanations of findings, and the collective experience of its expert authors"

"Pneumonia menjadi salah satu penyakit yang paling sering terjadi pada anak-anak berusia kurang dari 5 tahun. Gejala yang paling umum muncul pada anak dengan pneumonia adalah batuk, berdahak yang sulit dikeluarkan. Menurut beberapa penelitian fisioterapi dada menjadi intervensi keperawatan yang dapat diterapkan pada anak untuk membantu mengeluarkan sekret yang menghambat jalan napas. Tujuan penulisan ini adalah untuk menganalisis asuhan keperawatan pada pasien anak dengan pneumonia yang mengalami masalah bersihan jalan napas tidak efektif melalui penerapan intervensi fisioterapi dada. Terdapat 2 pasien yang diintervensi, masing-masing berusia 1 tahun 5 bulan dan 1 tahun 1 bulan. Intervensi dilakukan selama selama 3 hari. Setiap hari dilakukan fisioterapi dada sebanyak 2 kali (pagi dan sore) dengan durasi masing-masing 15 sampai 20 menit. Dari hasil evaluasi didapatkan adanya perbaikan status pernapasan pada pasien meliputi penurunan frekuensi napas dan denyut nadi, serta peningkatan saturasi oksigen. Selain itu, hasil auskultasi paru juga menunjukkan adanya penurunan suara ronchi.

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Pneumonia is one of the most common diseases in children under five years old. Coughing and phlegm that is difficult to expel are the most common symptoms of pneumonia in children. Chest physiotherapy can be applied to children to help expel secretions that block airways, according to several studies. The purpose of this paper is to analyze nursing care in pediatric patients with pneumonia who have problems with ineffective airway clearance through the application of chest physiotherapy interventions. There were 2 patients who intervened, each aged 1 year 5 months and 1 year 1 month. The intervention was carried out for 3 days. The chest physiotherapy was conducted twice a day for 15 to 20 minutes each. According to the evaluation results, the patient's respiratory status improved, including a decrease in respiratory rate and pulse, as well as an increase in oxygen saturation. In addition, the results of auscultation of the lungs also showed a decrease in the sound of rhonchi."

"Latar belakang: Kasus COVID-19 anak lebih jarang ditemukan daripada dewasa. Meskipun demikian, pada dasarnya anak tetap dapat terinfeksi SARS-CoV-2 dan turut berperan dalam transmisi penyakit. Pemeriksaan reverse transcription polymerase chain reaction (RT-PCR) merupakan baku emas untuk mendiagnosis COVID-19 namun memerlukan waktu relatif lama untuk memperoleh hasil. Radiografi toraks memiliki potensi menjadi modalitas diagnostik COVID-19 di masa pandemi. Sampai saat ini, belum ada penelitian terhadap penggunaan kategori gambaran radiografi toraks untuk menunjang diagnosis COVID-19 pada pasien anak.Metode: Penelitian ini dilaksanakan dengan desain potong lintang menggunakan data sekunder berupa hasil pemeriksaan radiografi toraks dan hasil RT-PCR terhadap 88 pasien anak di RSUPN Cipto Mangunkusumo mulai dari periode April 2020 hingga Oktober 2021, yang terdiri dari 22 pasien pneumonia COVID-19 dan 66 pasien pneumonia bukan COVID-19.Hasil: Analisis kappa Cohen untuk menilai kesesuaian antara kategori radiografi toraks (tipikal dan non-tipikal) dan hasil RT-PCR (pneumonia COVID-19 dan pneumonia bukan COVID-19) menunjukkan hasil nilai kappa ialah 0,22 (p = 0,033) yang mengindikasikan tingkat kesesuaian lemah namun bermakna.Simpulan: Tidak terdapat gambaran radiografi toraks yang khas pada anak dengan pneumonia COVID-19. Tidak terdapat kesesuaian yang baik antara kategori radiografi toraks dan hasil RT-PCR pada anak dengan pneumonia COVID-19.

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Background: COVID-19 pneumonia is rare in children. However, children may still be infected and transmit disease. RT-PCR is the gold standard in diagnosing COVID-19, although results may be delayed. Chest radiograph may have role in diagnosing COVID- 19. To dates, literature in chest radiograph categorization in diagnosing COVID-19 in children has yet to be found.

Method: This study used secondary data of chest radiographs and RT-PCR result from 88 children in RSUPN Cipto Mangunkusumo from April 2020 to October 2021.

Result: Kappa Cohen analysis of agreement between chest radiographic category and RT-PCR result showed kappa score of 0,22 (p = 0,033), indicating a weak agreement yet statistically significant.

Conclusion: There is no pathognomonic chest radiograph findings of COVID-19 pneumonia in children. Agreement between chest radiographic category and RT-PCR testing in paediatric COVID-19 pneumonia is poor."

"Latar belakang: Sindrom curah jantung rendah (low cardiac output syndrome, LCOS) merupakan salah satu morbiditas yang terjadi pascaoperasi jantung terbuka. Angka kejadian LCOS pada pasien pascaoperasi sebanyak 25–65%, sehingga diperlukannya suatu penanda biologis praoperatif untuk menilai keadaan pembedahan yang optimal. NT-proBNP merupakan suatu biomarker yang berpotensi digunakan dalam diagnosis, tata laksana dan prognosis pada populasi pediatrik. Penelitian ini bertujuan untuk mengevaluasi peran NT-proBNP sebagai faktor prediktor terhadap kejadian LCOS pascabedah jantung terbuka.Metode: Studi longitudinal dilakukan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita dalam periode November 2018 hingga Maret 2020 dengan merekrut subjek di bawah usia 18 tahun yang menjalani operasi korektif kelainan jantung bawaan. Kadar NT-proBNP prabedah diambil dan dianalisis terhadap kejadian LCOS pascaoperasi.Hasil: Terdapat 159 subjek dilibatkan sebagai subjek penelitian. Angka kejadian LCOS pascaoperasi sebanyak 23,9%. Median NT-proBNP prabedah berbeda bermakna antara pasien yang mengalami LCOS dengan pasien yang tidak mengalami LCOS (1592 pg/mL vs. 227 pg/mL; p = 0,001). Nilai cut-off NT-proBNP prabedah terhadap kejadian LCOS pascaoperasi adalah 400 pg/mL, dengan sensitivitas 78,95%, spesifisitas 64,46%, positive predictive value 41,10%, negative predictive value 90,70% dan diagnostic accuracy 67,92%.Simpulan: NT-proBNP prabedah dapat dijadikan faktor prediktor terhadap kejadian LCOS pascaoperasi jantung terbuka. Nilai cut-off NT-proBNP prabedah terhadap luaran LCOS pascaoperasi adalah 400 pg/mL.

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Background: Low cardiac output syndrome (LCOS) is a common morbidity following open heart surgery in pediatric population. The incidence of postoperative LCOS range from 25 to 65%, indicating the needs for preoperative tool to evaluate optimum condition prior to surgery. NT-proBNP is a biomarker that has potential in diagnosis, management, and prognosis in pediatric population. This study aims to evaluate the role of NT-proBNP as predictive factor for LCOS following cardiac surgery.

Methods: A longitudinal study was conducted in Harapan Kita National Heart Center between November 2018 and March 2020. We recruited subjects below 18 years old who underwent corrective cardiac surgery. NT-proBNP was obtained preoperatively and analyzed for postoperative LCOS.

Results: A total of 159 subjects were enrolled. The incidence of postoperative LCOS was 23.9%. The median of preoperative NT-proBNP was found to be significantly higher in patients experiencing LCOS compared to that of patients without LCOS (1592 pg/mL vs. 227 pg/mL; p = 0.001). The cut-off value for preoperative NT-proBNP to determine postoperative LCOS was 400 pg/mL with sensitivity of 78.95%, specificity of 64.46%, positive predictive value of 41.10%, negative predictive value of 90.70% and diagnostic accuracy of 67.92%.

Conclusions: Preoperative NT-proBNP can be used as predictor for postoperative LCOS following cardiac surgery. The cut-off value of preoperative NT-proBNP in determining postoperative LCOS was found to be 400 pg/mL."

"The textbook will describe the relationship between human cardiopulmonary system and exercise in a format that is related to the mode of exercise, health status and aging. It will include data regarding exercise training principles and the adaptations of the cardiopulmonary following, anaerobic, resistance and aerobic training. A more in-depth presentation of the cardiopulmonary system adaptations in pressing environments such as: warm, cold and altitude. Therefore, students will experience a depth and extent of content balanced with unique and effective learning features: It will help students find the way by both the text and subject matter. Knowing cardiopulmonary exercise function in health and disease will allow understand new research and findings relevant to cardiovascular status as assessed by cardiopulmonary exercise indices. It will bring together investigational exercise physiologists, cardiologists and scientists who share a wealth of experience needed to judge the cardiovascular status and function, and the impairments of patients with a variety of cardiac dysfunction. This book will provide a comprehensive, updated presentation of the information of the cardiovascular system as a whole, and its individual components."

"Hospital Acquired Bronkopneumonia merupakan salah satu jenis pneumonia yang timbul dalam 48 jam atau lebih setelah masuk rumah sakit. Gejala yang ditimbulkan pada anak dengan pneumonia adalah batuk berdahak dan anak sulit untuk mengeluarkan dahaknya. Hal ini menjadi masalah keperawatan bersihan jalan napas tidak efektif. Fisioterapi dada merupakan salah satu intervensi keperawatan yang digunakan untuk membantu mengeluarkan sekret dari jalan napas. Tujuan penulisan karya ilmiah ini adalah untuk mengetahui pengaruh fisioterapi dada pada anak dengan Hospital Acquired Bronkopneumonia. Karya tulis ilmiah ini ditulis berdasarkan hasil praktik mengelola pasien selama enam hari di salah satu rumah sakit di Depok. Hasil menunjukkan bahwa tindakan keperawatan fisioterapi dada terbukti efektif untuk membantu mengeluarkan sekret dari jalan napas dan memperbaiki status pernapasan. Hasil karya tulis ilmiah ini diharapkan dapat menjadi studi rekomendasi intervensi keperawatan mandiri yang dilakukan dalam upaya meningkatkan bersihan jalan napas pasien anak.

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Hospital Acquired Bronchopneumonia is a type of pneumonia that appears within 48 hours or more after entering the hospital. Symptoms that occur in children with pneumonia are coughing up phlegm and it is difficult for the child to expel the phlegm. This is a problem of ineffective airway clearance nursing. Chest physiotherapy is a nursing intervention used to help remove secretions from the airway. The purpose of writing this scientific work is to determine the effect of chest physiotherapy on children with Hospital Acquired Bronchopneumonia. This scientific paper was written based on the results of practice in managing patients for six days at a hospital in Depok. The results show that chest physiotherapy nursing procedures have proven effective in helping to remove secretions from the airway and improve respiratory status. It is hoped that the results of this scientific paper can become a study of recommendations for independent nursing interventions carried out in an effort to improve airway clearance for pediatric patients."

"[Stress proof the heart presents a general picture of behavioral cardiology while focusing in depth on critical specifics. Leading experts in the field explore the psychological aspects of living with arrhythmia, intracardiac device, heart failure, and heart transplant, relating them to psychological characteristics such as pessimism and the feeling of overcommitment. Mainstream treatments, such as stress management and smoking cessation, and emerging interventions, such as computer-based therapies and personality-based techniques., Stress proof the heart presents a general picture of behavioral cardiology while focusing in depth on critical specifics. Leading experts in the field explore the psychological aspects of living with arrhythmia, intracardiac device, heart failure, and heart transplant, relating them to psychological characteristics such as pessimism and the feeling of overcommitment. Mainstream treatments, such as stress management and smoking cessation, and emerging interventions, such as computer-based therapies and personality-based techniques.]"

"Pathologists and pathology residents, look no further: Biopsy Interpretation: Pediatric Lesions is your practical, essential guide to pediatric biopsies. This how-to guide is the perfect bench reference for both the pediatric pathologist tasked with interpreting pediatric biopsies and the general surgical pathologist. Authored by a panel of top experts, the topics covered include a wide spectrum of diseases that afflict children, laying a comprehensive framework for diagnosing both the common and not-so-common diseases that can be identified by biopsy. If you{u2019}re a medical professional faced with the challenge of interpreting pediatric biopsies, this reference will prove indispensable to your day-to-day life."

"ABSTRAKPenyakit jantung bawaan asianotik yang merupakan sebagian besar dari penyakit jantung bawaan memerlukan operasi bedah jantung terbuka untuk memperbaiki kelainannya. Sindrom curah jantung rendah masih merupakan masalah yang dihadapi pada pasien pediatrik pascabedah jantung terbuka. Deteksi sindrom curah jantung rendah yang ada sekarang menggunakan kriteria klinis dan indikator laboratorik masih belum dirasa cukup, yang terbukti dengan masih adanya angka morbiditas dan mortalitas. Peranan penanda biologis NT-proBNP telah berkembang di gagal jantung dewasa diharapkan dapat digunakan untuk dapat mendeteksi sindrom curah jantung rendah pada pediatrik.Penelitian cross sectional observasional dengan jumlah 38 subjek yang memenuhi kriteria inklusi dan eksklusi yang menjalani operasi jantung bawaan asianotik bulan Oktober-November 2018 di Rumah Sakit Jantung dan Pembuluh darah Nasional Harapan Kita, Indonesia. Data prabedah, intrabedah dan pascabedah termasuk kejadian sindrom curah jantung rendah dicatat. Kadar NT-proBNP akan diambil prabedah, 4 jam, 24 jam dan 72 jam pascabedah. Analisis data menggunakan uji Mann-Whitney.Kadar NT-proBNP prabedah, 4 jam pascabedah dan 24 jam pascabedah berbeda bermakna dengan kejadian sindrom curah jantung rendah (nilai p <0,05). Kadar NT-proBNP prabedah memiliki perbedaan rerata lebih rendah dibandingkan dengan kadar NT-proBNP 4 jam pascabedah yang juga lebih rendah dibandingkan kadar NT-proBNP 24 jam pascabedah dan hal ini berbeda bermakna (p <0,001). Sedangkan kadar NT-proBNP 72 jam pascabedah memiliki rerata lebih rendah dibandingkan dengan kadar NT-proBNP 24 jam pascabedah yang juga berbeda bermakna (p <0,001). Analisis kadar NT-proBNP dengan variabel lainnya mendapatkan hasil berbeda bermakna dengan variabel usia, jenis kelamin, berat badan, diagnosis PJB, durasi ventilasi mekanik dan durasi ICU.Kadar NT-proBNP berhubungan dengan kejadian sindrom curah jantung rendah. Kadar NT-proBNP yang tinggi menunjukkan adanya kejadian sindrom curah jantung rendah (pada kadar NT-proBNP prabedah, 4 jam dan 24 jam pascabedah).

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ABSTRACT"

"Peran NT-proBNP sebagai penanda biologis untuk mengetahui terjadinya sindrom curah jantung rendah pada pasien pediatrik dengan penyakit jantung bawaan sianotik pascabedah jantung terbuka belumlah diketahui. NT-proBNP diharapkan dapat menjadi penanda sindrom curah jantung rendah sehingga dapat mengurangi morbiditas dan mortalitas. Penelitian cross sectional ini melibatkan 40 pasien pediatrik dengan penyakit jantung bawaan sianotik yang menjalani pembedahan jantung terbuka di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, selama bulan Maret 2019-April 2019. Terdapat perbedaan bermakna antara kadar NT-proBNP prabedah, 4 jam pascabedah, 24 jam pascabedah dan 72 jam pascabedah terhadap kejadian sindrom curah jantung rendah (p<0,001). Kadar NT-proBNP tertinggi pada 24 jam pasca bedah dengan perbedaan bermakna terhadap kadar NT-proBNP prabedah (p<0,001), 4 jam pascabedah dan 72 jam pascabedah (p<0,001). Diperoleh pula variabel lain yang berhubungan secara bermakna dengan NT-proBNP yaitu usia, berat badan, jenis penyakit jantung bawaan sianotik, lama aortic cross clamp, lama cardiopulmonary bypass, lama ventilasi mekanik dan lama rawat PICU. Dapat disimpulkan bahwa kadar NT-proBNP yang tinggi sebagai penanda kejadian sindrom curah jantung rendah.

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The role of NT-proBNP as a biological marker to determined the occurrence of low cardiac output syndromes in pediatric patients with cyanotic congenital heart disease after open heart surgery was unknown. NT-proBNP was expected to be a marker of low cardiac output syndrome so that it can reduce morbidity and mortality. This cross-sectional study involved 40 pediatric patients with cyanotic congenital heart disease who underwent open heart surgery at National Cardiovascular Centre Harapan Kita, during March 2019-April 2019. There were significant differences between pre-operative levels of NT-proBNP, 4 hours postoperatively, 24 hours postoperatively and 72 hours postoperatively with the incidence of low cardiac output syndrome (p <0.001). The highest NT-proBNP level was 24 hours postoperatively with a significant difference in preoperative levels of NT-proBNP (p <0.001), 4 hours postoperatively and 72 hours postoperatively (p <0.001). Other variables that were significantly associated with NT-proBNP were age, body weight, type of cyanotic congenital heart disease, duration of aortic cross clamp, duration of cardiopulmonary bypass, duration of mechanical ventilation and length of stay of PICU. It can be concluded that high NT-proBNP level as a marker of low cardiac output syndrome."